Scotland’s NHS medicines gatekeeper, the Scottish Medicines Consortium (SMC), has agreed that adults living with HIV can be given a new two monthly injection for the first time.

The decision means that people living with HIV in Scotland will be the first in the UK to be able to move across onto the six times a year regimen after a managed transition period.

Cabotegravir (Vocabria), in combination with rilpivirine, is the first long-acting injectable treatment for human immunodeficiency virus type 1 infection. Cabotegravir and rilpivirine are administered in an injection into a muscle, by a healthcare professional, every two months.

SMC chairman Mark MacGregor said:

“For those living with HIV, cabotegravir injection offers another option compared to current treatments that all require tablets to be taken every day.”

Brian West of the European AIDS Treatment Group said the move from daily to two-monthly treatment is about much more than convenience:

“Thankfully, huge progress has been made in the management of HIV over the last 40 years, with new treatments expanding much needed choice for people living with HIV.

“But sadly, stigma remains a reality for some people, and taking a tablet each day can act as both a constant reminder of their HIV status and increase the risk of that status being shared against their will.

“The option of a long-acting injectable therapy could be a real game-changer for a number of people with HIV in Scotland, providing ’treatment privacy’ for some and providing relief of the daily grind of taking tablets for others.”

In all, SMC accepted six out of seven medicines that came up for final decisions at its meeting last month, the results of which have just been published. Another two were rejected on the basis that the companies behind them had not asked for them to be used.

Meanwhile, the decision to allow the first targeted treatment for prostate cancer with specific gene mutations, Olaparib (Lynparza), has been welcomed by David Ferguson, public affairs manager for Cancer Research UK in Scotland:

“It’s great news that olaparib has been approved to treat metastatic prostate cancer for people in Scotland who carry BRCA1 and BRCA2 gene mutations. 

“Around 1 in 400 people in the UK have the BRCA1 or BRCA2 gene mutations, both of which are associated with an increased risk of developing prostate cancer. Olaparib is a really important tool for treating patients with these mutations who have cancer which has come back after chemotherapy.

“Cancer Research UK played a leading role in the first clinical trials for olaparib, which led to it being used routinely to treat ovarian cancer in patients who have the BRCA1 and BRCA2 gene faults and it’s really encouraging that olaparib can be now be used for more types of cancer.

“For those advanced prostate cancer patients who can now get olaparib, today’s decision will offer them a treatment option which can give them time to make more memories with their loved ones.”

SMC says olaparib is taken orally, potentially reducing the number of hospital trips required compared to current treatment options involving chemotherapy. The organisation says olaparib can prolong the time until the disease progresses and may have fewer side effects than current treatment options.

Olaparib (Lynparza) was brought to market by AstraZeneca.

The HIV treatment is the result of a collaboration between two companies, with ViiV Healthcare’s cabotegravir used in combination with Janssen’s rilpivirine.

 

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